(A)
Introduction: All goods or services paid,
in whole or in part, with Older Americans Act funds are subject to voluntary
contributions. All services paid, in whole or in part, with Older Americans Act
funds are subject to cost sharing, except for goods or services excluded by
paragraph (C)(1) of this rule.

(1)
Each provider
shall allow consumers to contribute towards the provision of goods or services
paid, in whole or in part, with Older Americans Act funds, pursuant to section
315(b)(1) of the Older Americans Act and
45 C.F.R. 1321.67(a)(1) . The provider may
solicit consumers to contribute toward the cost of the goods and services they
receive and shall encourage any consumer to contribute if the consumer's
self-declared income is at, or above, one hundred eighty-five per cent of the
federal poverty guidelines, which the United States department of
health and human services establishes annually according to section 673(2) of
the Omnibus Reconciliation Act of 1981, 95 Stat. 511,
42 U.S.C. 9902 and publishes on
https://aspe.hhs.gov/poverty-guidelines.

(2)
The provider shall clearly inform each
consumer that contributions are purely voluntary.

(3)
The provider shall protect the privacy of
each consumer with respect to his or her contribution.

(4)
The provider shall safeguard and account
for all voluntary contributions.

(5)
The provider may develop a suggested
contributions schedule for voluntary contributions according to
45 C.F.R. 1321.67(c) .

(6)
The provider shall use collected
voluntary contributions to expand the goods or services for which consumers
contributed and supplement (not supplant) Older Americans Act funds for those
goods or services.

(e)
Transportation, although the AAA may apply to ODA for a waiver of this
exemption if the transportation is coordinated with other services and is paid,
in whole or in part, with Older Americans Act funds.

(2)
Each AAA shall implement and administer a
cost-sharing policy that includes all of the following:

(a)
The policy shall include the sliding-fee
schedule below, which determines the percentage of the actual (or partial)
contracted cost of a unit of a good or a service provided that the AAA shall
suggest that a consumer pay based upon the consumer's individual income as a
percentage of the federal poverty guideline. Under no circumstances shall an AAA
permit or require a consumer to participate in cost sharing when the consumer's
income is below one hundred fifty per
cent of the federal poverty guideline.

Sliding-fee Schedule

INCOME

SUGGESTED COST SHARE

149% and below

0%

150-174%

10%

175-199%

20%

200-224%

30%

225-249%

40%

250-274%

50%

275-299%

60%

300-324%

70%

325-349%

80%

350-374%

90%

375% and above

100%

(b)
The
policy shall include a requirement to determine the consumer's income solely by
the consumer's self-declaration of income with no requirement for verification,
and no consideration of the consumer's assets, savings, or other
property.

(c)
The policy shall
include a procedure for collecting cost-sharing payments from consumers,
including from consumers receiving consumer-directed services.

(d)
The policy shall include a requirement to
widely distribute written materials to consumers that describe the requirements
for cost sharing, the services subject to cost sharing, the procedure for cost
sharing, and the sliding-fee schedule published in this rule. The written
materials shall also state that a provider shall not deny any goods or services
paid, in whole or in part, by Older Americans Act funds if the consumer fails
to make a cost sharing payment towards those goods or services.

(e)
The policy shall include a requirement to
provide a receipt to a consumer or caregiver who makes a payment.

(f)
The policy shall include a procedure for
safeguarding and accounting for all cost-sharing funds collected.

(g)
The policy shall include a requirement to
retain records of all cost-sharing funds collected.

(h)
The policy shall include a requirement to
keep the consumer's declaration of income (or non-declaration of income) and
cost-sharing payment history confidential.

(i)
The policy shall include a requirement to
use the funds collected from cost sharing to expand the capacity to provide the
service for which the funds were given, unless the funds are used to expand the
pool of funds from which the care-coordinated services are paid.

(3)
The AAA may delegate the
administration of its cost-sharing policy to providers with whom it enters into
an AAA-provider agreement under rule
173-3-06
of the Administrative Code.

(4)
The
AAA may request a waiver from paragraph (C)(3) of this rule to implement and
administer a cost-sharing policy. ODA shall approve the request if the AAA
demonstrates to ODA, by a preponderance of the evidence, one or more of the
following:

(a)
At least eighty per cent of
the consumers in the PSA have incomes below one hundred fifty per cent of the
federal poverty level.

(b)
Cost
sharing generates fewer funds in the PSA than the funds required to cover its
annual, ongoing administrative expenses.

(c)
A waiver is necessary in order for the
services normally subject to this rule to be coordinated with other service
systems.